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What is infective endocarditis (previously called bacterial endocarditis)?

refers to a microbial infection
ex: virus
bacteria
fungi
involves endocardium...
a healthy, defective, or prosthetic valve can be affected, but infection may also occur in apparently healthy endocardium or in septal defects

How do cardiac defects cause endocardium erosion and what is the pathophysiology of endocarditis?

bacteria become trapped in the low-pressure "sinkhole" and are deposited in the vegetation...what is then deposited?

valvular insufficiency...at some point, the vegetation may become so large that the blood flow through the valve is obstructed...this is a form of?

blood flows rapidly from a high-pressure area to a low-pressure zone...platelets and fibrin adhere to the denuded endocardium which forms a vegetative lesion...what happens during bacteremia?

additional platelets and fibrin which causes the vegetative lesion to grow...this destroys theh endocarium and valve...what is the condition called when the lesion interferes with normal alignment of the valve?

antimicrobials for up to 4-6 weeks IV that are strong enough to penetrate the vegetation protecting the microorganism...penicillin and cephalosporins are preferred

IV therapy is started at hospital for a few days and then patient can continue IV therapy at home after they show evidence of no fever, have negative blood cultures, and have no signs of HF or emoblization

What's the scoop on anticoagulants...are the given or not?

Avoid use of anticoagulants...they're ineffective at preventing embolization of vegetation...they may result in bleeding...only recommended if they are required to prevent thrombus formation on a prosthetic valve

Complete bedrest is not necessarily needed unless?

patient is hemodynamically unstable...balance activities with rest...it's important to have proper oral treatment and general body hygeine and consistently use appropriate aseptic technique to protect client from contact with infective organisms

if antibiotic therapy is ineffective in sterilizing a valve...
if refractory HF develops secondary to a defective valve...
if refractory HF develops secondary to a defective valve...
if large valvular vegetations are present...
if multiple embolic events
occur

Current surgical interventions for infective endocarditis include the following? (4)

supplies on hand?
prepared antibiotic
IV pump with tubing
alcohol wipes
IV access device
normal saline solution
heparin and saline lock
flush solution drawn up
in syringes
saline lock, peripherally
inserted central catheter
(PICC line), or central
catheter is positioned at
a venous site tht is easily
accessible
teach patient how to
administer antibiotic and
care for infusion site
contact patient every 3-7
days to see how he's doing
encourage proper hygeine..
use a soft toothbrush..
brush teeth twice per day..
don't use irrigation
devices or floss teeth
because bacteremia may
result
instruct patient to cleanse
lacerations well and apply
an antibiotic ointment

tell dentist and other doctors about IE and start antibiotics before every invasive procedure